Effects of Social Media on Adolescents’ Willingness and Intention to Use E-Cigarettes: An Experimental Investigation

TLDR

The study aimed to assess how experimentally manipulated social media exposure—varying by source (peer vs advertisement) and e‑cigarette content intensity (heavy vs light)—affects adolescents’ willingness, intention, attitudes, perceived norms, and perceived danger regarding e‑cigarette use, and how daily social media use intensity relates to these outcomes. A between‑subjects experiment with 135 California adolescents (age 13‑18) exposed to six online posts in a 2×2 design (post source × content intensity) was conducted, and analyses were weighted to population benchmarks. Results showed that higher daily social media use and exposure to heavy e‑cigarette content or advertisements increased willingness, intention, positive attitudes, and perceived norms while reducing perceived danger, with no significant interaction, indicating a heightened risk for adolescent e‑cigarette use and a need for regulatory action to ban sponsored content.

Abstract

This study examined the effects of experimentally manipulated social media exposure on adolescents' willingness and intention to use e-cigarettes.Participants were 135 adolescents of age 13-18 (52.6% female, mean age = 15.3) in California. Participants viewed six social media posts online in a 2 (post source: peer or advertisement) × 2 (e-cigarette content exposure: heavy or light) between-subjects design. Analyses were weighted to population benchmarks. We examined adolescents' beliefs, willingness, and intention to use e-cigarettes in association with social media use intensity in daily life and with experimentally manipulated exposure to social media posts that varied by source (peer or advertisement) and content (e-cigarette heavy or light).Greater social media use in daily life was associated with greater willingness and intention to use e-cigarettes and more positive attitudes, greater perceived norms, and lower perceived danger of e-cigarette use (all p-values <.01). In tests of the experimental exposures, heavy (vs. light) e-cigarette content resulted in greater intention (p = .049) to use e-cigarettes and more positive attitudes (p = .019). Viewing advertisements (vs. peer-generated posts) resulted in greater willingness and intention (p-values <.01) to use e-cigarettes, more positive attitudes (p = .003), and greater norm perceptions (p = .009). The interaction effect of post source by post content was not significant for any of the outcomes (all p-values >.529).Greater social media use and heavier exposure to advertisements and e-cigarette content in social media posts are associated with a greater risk for e-cigarette use among adolescents. Regulatory action is needed to prohibit sponsored e-cigarette content on social media platforms used by youth.Adolescents who use social media intensely may be at higher risk for e-cigarette use. Even brief exposure to e-cigarette content on social media was associated with greater intention to use and more positive attitudes toward e-cigarettes. Regulatory action should be taken to prohibit sponsored e-cigarette content on social media used by young people, including posts by influencers who appeal to young people.